Are you still wearing face mask protection when you go out? You should be! A new commentary from one of the leading medical journals in the world suggests that face masks may not only be reducing the severity of COVID-19 cases but could also be giving people immunity from the illness. Consequently, this means that a greater proportion of new infections are asymptomatic.
Infectious Dose = Illness Severity?
Published in the New England Journal of Medicine, the piece gives further support for the promising yet unproven theory that universal face mask-wearing is reducing COVID-19 severity in infected populations. If validated, then mass face mask-wearing could actually be a form of inoculation that generates immunity. This information could prove invaluable in slowing down the spread of the deadly pandemic. Currently, COVID-19 affects more than 2.5 million people in the United States alone.
Evidence has been mounting that the amount of coronavirus that someone is exposed to at the beginning of their infection — known as the infectious dose — may be the main determinant of their illness severity. A large study recently published in The Lancet supports this concept; it found that "viral load at diagnosis" was an "independent mortality predictor" in COVID-19 patients in hospitals.
Face masks filter out some of the virus-containing droplets that people come into contact with. So they also reduce the infectious doses that wearers are exposed to. Consequently, this could nullify the disease's impact.
More Masks Worn = More Lives Saved
If the theory pans out, researchers believe that population-wide mask-wearing could ensure that a higher proportion of the COVID-19 infected population stays asymptomatic. Buttressing this is recently emerged data that suggests even a mild or asymptomatic coronavirus infection could be enough to yield a strong immune response. With that said, researchers emphasize that public health strategies and coronavirus protection measures that reduce illness severity, such as mask-wearing, should also increase population-wide immunity.
You may be wondering, why is this? Because a low viral load can effectively act as a typical vaccine does — it's not enough to hurt you, but it is enough to induce an immune response from your body.
This hypothesis requires more clinical studies. Though, an experiment with hamsters has hinted at a connection between dose amount and disease severity. Earlier in 2020, Chinese researchers placed hamsters behind a barrier of masks. They found that COVID-19 was less likely to infect these protected critters. But the ones who did contract the virus became noticeably less sick than their counterparts without any mask protection.
Human observations support this study's findings. For instance, a coronavirus outbreak occurred on an Argentinian cruise ship. Passengers wore surgical masks, while the staff donned N95 masks. In this case, the rate of asymptomatic infection was 81 percent. Earlier cruise ship coronavirus outbreaks without any universal masking protocols only had a 20 percent asymptomatic infection rate.
More Testing Is Needed
Dr. Monica Gandhi is an infectious disease doctor at the University of California. She is also one of the New England Journal of Medicine paper's authors. She stresses that, due to its limitations, the commentary should only be seen as a theory at the moment.
Gandhi explains to The Telegraph, "To test the variolation hypothesis, we will need more studies comparing the strength and durability of SARS-CoV-2–specific T-cell immunity between people with asymptomatic infection and those with symptomatic infection, as well as a demonstration of the natural slowing of SARS-CoV-2 spread in areas with a high proportion of asymptomatic infections."
However, Gandhi does emphasize that, if masking does increase the proportion of asymptomatic infection, it probably also increases the population proportion who has a short-term immunity to COVID-19. If confirmed, such an insight would be priceless as the world awaits a vaccine for this sickness.
Dr. Julian Tang, a University of Leicester Honorary Respiratory Sciences Associate Professor, shares Gandhi's caution and optimism: "This idea of 'variolation' - a term originally derived from the smallpox pre-vaccine era - is quite feasible and may add to the protective physical effects of universal masking - by low-level stimulation of the wearer's immune system as it is exposed to low levels of airborne SARS-CoV-2, which can induce an immune response but without any overt infection and disease."
Wear a Face Mask!
Tang does note that the data they have seen does mirror the response normally seen from a typical vaccine. Still, both doctors emphasize that more formal studies are certainly needed to confirm whether this is true or not. And around the world, a plethora of natural experiments are occurring as we write this.
In this matter, it's always better to be prudent and conservative. So wear a face mask!
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